Barack Obama hasn’t officially taken office yet, and the “shift of power” in the U.S. senate is still to be decided — but that doesn’t mean we aren’t privvy to the possibilities for the methods in which the legislative branch will approach the skyrocketing costs of healthcare in this country.

The NYT sees it this way: Congress should curb the tremendous growth of Medicare Advantage alignments.  If CMS cannot effectively monitor its own out-of-control administrative costs, then how can it even begin to rein in the expenses incurred by its association with private fee-for-service plans with respect to the beneficiary?

Back in the 1980s, private plans — known as health maintenance organizations — were seen as a savior for Medicare. They could provide the same or better services as traditional fee-for-service Medicare, but because of managed care they could do it at a lower cost. Over the years Congress brought other, less managed private plans into Medicare, and in 2003 the Republican-dominated Congress substantially increased government payments to private plans.

Medicare currently pays the private plans — now called the Medicare Advantage program — 13 percent more on average than the same services would cost in the traditional fee-for-service program. Some of the added payments are used to provide extra benefits for enrollees, like reduced cost-sharing or reduced premiums for such extra benefits as vision and dental care.

Barack Obama is on board with eliminating taxpayer subsidies to pay for these plans.  Hopefully, this represents change (at least in the publicly-financed healthcare sector) he believes in and will implement.

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